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19 Cards in this Set
- Front
- Back
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Number one cancer killer of women in the developing world?
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Cervical cancer
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Define: CIN I, II, III
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CIN I: changes in lower 1/3 of cervical epithelium
CIN II: 2/3 CIN III: full thickness |
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Define: Transformation zone
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Junction between squamous keratinized (ectocervix) and columnar epithelium (endocervix)
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Conditions that make you not need to have a pap smear
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-70 years old w/ 3 or more normal paps in a row
*total* hysterectomy w/ no history of abnl paps (note that supracervical hysterectomy pts still need it) |
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What percentage of ASCUS cells are cancer?
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10-15% of ASC harbor dysplasia
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A patient gets a pap smear and ASCUS cells are seen. What is the next step, and how would it differ from ASC-H (atypical squamous cells, cannot exclude high grade squamous intraepithelial lesion)
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ASCUS: undergo HPV testing to see if colposcopy is indicated
ASC-H: colposcopy |
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Next step for pts with LSIL?
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colposcopy
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Next step for patients with HSIL?
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colposcopy
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Next step for patients with AGC?
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colposcopy, cervical biopsy, EMB if 35+
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A patient with ASCUS has a reflex HPV test. What are the next steps if....
a) high risk HPV types are found (16,18) b) low risk HPV types are found (6,11) |
a) colposcopy, biopsy
b) another pap smear w/ another high risk HPV screen |
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Explain the rationale behind the 'next step' for ASC-H, LSIL, and HSIL
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All of these have colposcopy as the next step. We don't do HPV reflex testing because it is a good bet that they will be positive for the high risk HPV types
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A patient has a pap smear and SCC (squamous cell carcinoma) is found. Next step?
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Colposcopy, cervical biopsy, conization/excision
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what is a colposcopy good for?
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it is a means of visualizing the cervix, and is a way to achieve a directed biopsy
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A patient is diagnosed with CIN w/ a cervical biopsy. What is the next step?
----> What's the next, next step assuming the worst? |
Repeat pap smear or HPV testing
If either are positive ---> *repeat colposcopy and biopsy* |
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What types of intraepithelial neoplasias are treated with excision?
-types of excisional techniques |
CIN II and III, plus CIN I that has persisted for 2+ years.
1) cold knife conization 2) Loop electrosurgical excision procedure (LEEP) |
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What is the excisional technique for cervical cancer that is large or in a teenager?
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Laser conization --> this is a more precise way of excision vaginal tissue
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In someone with cervical cancer, the most common symptom is...
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...postcoital bleeding
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Are pap smears sufficient to diagnose cancer?
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No! tissue biopsy is needed!
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Briefly explain the 4 stages of cervical cancer
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I: confined to cervix
II: extends beyond cervix III: extends to pelvic sidewalls or lower 1/3 of vagina IV: extension beyond the pelvis (ie bladder, rectum, distant mets) |
